Proglucagon peptide secretion profiles in type 2 diabetes before and after bariatric surgery: 1-year prospective study
| Autor: | Anna Kamocka, Matthieu Fleuret, Paul Bech, Robert Wheller, George Tharakan, Jens J. Holst, Bernard Khoo, Nicolai J. Wewer Albrechtsen, Joyceline Cuenco, Stephen R. Bloom, Sanjay Purkayastha, Tricia Tan, Ibiyemi Ilesanmi, Kleopatra Alexiadou, James W Howard, Preeshila Behary, Ahmed R. Ahmed |
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| Přispěvatelé: | National Institute for Health Research |
| Rok vydání: | 2020 |
| Předmět: |
obesity
Endocrinology Diabetes and Metabolism Y GASTRIC BYPASS Type 2 diabetes Proglucagon chemistry.chemical_compound RECEPTOR ANTAGONIST 0302 clinical medicine Prospective Studies OXYNTOMODULIN 030212 general & internal medicine GLICENTIN GLUCAGON-LIKE PEPTIDE-1 digestive oral and skin physiology Glucagon secretion Peptide secretion Glucagon-like peptide-1 Postprandial HORMONES Life Sciences & Biomedicine Obesity Studies hormones hormone substitutes and hormone antagonists endocrine system medicine.medical_specialty glucagon-like peptide-1 (GLP-1) bariatric surgery Gastric Bypass WEIGHT-LOSS 030209 endocrinology & metabolism Glucagon Diseases of the endocrine glands. Clinical endocrinology Endocrinology & Metabolism 03 medical and health sciences BETA-CELL FUNCTION medicine Humans Science & Technology business.industry nutritional and metabolic diseases 1103 Clinical Sciences RC648-665 medicine.disease Surgery Oxyntomodulin Diabetes Mellitus Type 2 glucagon chemistry GLUCOSE-TOLERANCE GLP-1 business |
| Zdroj: | BMJ Open Diabetes Research & Care, Vol 8, Iss 1 (2020) BMJ Open Diabetes Research & Care Alexiadou, K, Cuenco, J, Howard, J, Wewer Albrechtsen, N J, Ilesanmi, I, Kamocka, A, Tharakan, G, Behary, P, Bech, P R, Ahmed, A R, Purkayastha, S, Wheller, R, Fleuret, M, Holst, J J, Bloom, S R, Khoo, B & Tan, T M M 2020, ' Proglucagon peptide secretion profiles in type 2 diabetes before and after bariatric surgery : 1-year prospective study ', B M J Open Diabetes Research & Care, vol. 8, no. 1, e001076 . https://doi.org/10.1136/bmjdrc-2019-001076 |
| ISSN: | 2052-4897 |
| Popis: | IntroductionHyperglucagonemia is a key pathophysiological driver of type 2 diabetes. Although Roux-en-Y gastric bypass (RYGB) is a highly effective treatment for diabetes, it is presently unclear how surgery alters glucagon physiology. The aim of this study was to characterize the behavior of proglucagon-derived peptide (glucagon, glucagon-like peptide-1 (GLP-1), oxyntomodulin, glicentin) secretion after RYGB surgery.Research design and methodsProspective study of 19 patients with obesity and pre-diabetes/diabetes undergoing RYGB. We assessed the glucose, insulin, GLP-1, glucose-dependent insulinotropic peptide (GIP), oxyntomodulin, glicentin and glucagon responses to a mixed-meal test (MMT) before and 1, 3 and 12 months after surgery. Glucagon was measured using a Mercodia glucagon ELISA using the ‘Alternative’ improved specificity protocol, which was validated against a reference liquid chromatography combined with mass spectrometry method.ResultsAfter RYGB, there were early improvements in fasting glucose and glucose tolerance and the insulin response to MMT was accelerated and amplified, in parallel to significant increases in postprandial GLP-1, oxyntomodulin and glicentin secretion. There was a significant decrease in fasting glucagon levels at the later time points of 3 and 12 months after surgery. Glucagon was secreted in response to the MMT preoperatively and postoperatively in all patients and there was no significant change in this postprandial secretion. There was no significant change in GIP secretion.ConclusionsThere is a clear difference in the dynamics of secretion of proglucagon peptides after RYGB. The reduction in fasting glucagon secretion may be one of the mechanisms driving later improvements in glycemia after RYGB.Trial registration numberNCT01945840. |
| Databáze: | OpenAIRE |
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